There’s no cookbook for this problem

Protocols and mandates cannot govern all of medical practice. Few better examples of cookbook failure exist than the decision-making surrounding the Medtronic Sprint Fidelis lead. You may know the story already. Here’s my brief summary: In the early 2000’s, Medtronic released a family of defibrillator leads that were promoted as thinner and easier to maneuver. […]

Doctoring ICD/Pacemaker Knowledge Reflection

Clinical decision making 301: The Sprint Fidelis ICD lead…

The implantable defibrillator (ICD) is an amazing life-saving device.  When used in the appropriate patient, the scientific data supporting its benefit is rock solid. The sudden death-averting appropriate ICD shock in the middle of the night, allows the patient to enjoy breakfast with his spouse, rather than admission to the morgue. ICD function seems simple: […]